• Stephen Peckham.
• Director, Centre for Health Services, Studies Professor of Health Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine Director, Policy Research Unit in Commissioning and the Healthcare System, University of Kent, Canterbury, UK.
• Healthc Policy. 2014 Sep 1; 10 (Spec issue): 154-62.

AbstractRecent changes in the English National Health Service (NHS) have introduced new complexities into the accountability arrangements for healthcare services. This commentary describes how the new organizational structures have challenged the traditional centralized accountability structures by creating a more dispersed system of governance for local health-care commissioners. It sets the context of discussions about accountability in the UK NHS and then describes the key changes in England following the implementation of the NHS reforms in April 2013. The commentary concludes that while there is increased complexity of accountability within a more decentralized and fragmented healthcare system, the government's goal of achieving increased local autonomy and greater control by general practitioners (GPs) will probably not be realized. In particular, the system will continue to have strongly centralized aspects, with increased regulation and central political responsibility.Copyright © 2014 Longwoods Publishing.

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